Parasites and Biliary stones
Parasites and Biliary stones
Parasites and Biliary stones
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Endoscopic retrograde cholangiopancreatography ١٠٧<br />
Figure (18): Double-duct sign in ERCP (quoted from Albert <strong>and</strong> Rilemann,<br />
Ampullary adenomas:<br />
2002).<br />
Adenomas in the region of the major duodenal papilla can be both<br />
diagnosed <strong>and</strong> treated via ERCP. Snare ampullectomy, combined with<br />
biliary <strong>and</strong>/or pancreatic sphincterotomy, allows complete removal of the<br />
adenoma in approximately 80% to 90% of patients without intraductal<br />
extension. Recurrences are more common in patients with familial<br />
adenomatous polyposis syndrome (Norton et al., 2002).<br />
Preparation <strong>and</strong> technique:<br />
(i) Preparation:<br />
Preparation for ERCP involves assembly of a skilled team that<br />
includes physician (S), nursing personnel, <strong>and</strong> a radiology technician. A<br />
quality flouroscopic unit is needed. A wide variety of catheters, guide<br />
wires, stone extraction balloons <strong>and</strong> baskets, sphincterotomes, stents,<br />
drainage catheters, lithotripters, <strong>and</strong> tissue sampling devices should be<br />
available (Whitehouse et al., 1996).
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